Paying for Home Health Care: What Does Medicare Cover?

As of April 1st, Medicare implements new regulations for covering skilled home health care under Medicare Part A. In order for Medicare to pay for covered home health services, the patient will need a face to face visit with the ordering physician within a specific time frame. You can read more about these new regulations on EasyLiving’s Home Care Blog.

Do you know when Medicare pays for home health care? Medicare covers skilled home health services, such as physical therapy or R.N. services. Paying for home health care via Medicare requires the following conditions:

• The patient must be homebound and under a doctor’s care.
• The patient must need skilled nursing care, or occupational, physical or speech therapy, on at least an intermittent basis (that is, regularly but not continuously).
• The services provided must be under a doctor’s supervision and performed as part of a home health care plan written specifically for that patient.
• The patient must be eligible for the Medicare program and the services ordered must be “medically reasonable and necessary”.
• The home health care agency providing the services must be certified by the Medicare program.

Medicare generally does not cover custodial care (also known as long term care services). Licensed Florida home care companies like EasyLiving typically provide day to day care, help around the house, and assistance with activities of daily living, which are paid for on a fee for service basis or via long term care insurance.

Aging Wisely’s geriatric care managers can help you navigate your Medicare and long term care insurance coverage, understand eldercare costs and options, as well as identify public benefits and Florida senior resources for which you might be eligible.